Artificial insemination (AI), particularly intrauterine insemination (IUI), is a widely used fertility treatment that increases the chances of conception by placing sperm directly into the uterus. This procedure is less invasive and more affordable compared to in vitro fertilisation (IVF), making it a popular choice for individuals and couples struggling with infertility.

This article provides a detailed overview of artificial insemination, including its process, types, success rates, advantages, risks, and ideal candidates.

What Is Artificial Insemination?

Artificial insemination is a reproductive technique in which processed sperm is introduced into a woman’s uterus to facilitate fertilisation. The sperm used for this procedure can be obtained from:

A Partner (Homologous AI or AIH): Also known as conjugal artificial insemination (CAI), this method utilizes the sperm of the woman’s partner.
A Donor (Heterologous AI or AID): Sperm from a donor is used when the male partner’s sperm is unsuitable due to infertility, genetic concerns, or when the procedure is performed for a single woman or a same-sex female couple.

The likelihood of pregnancy through AIH (Artificial insemination by husband) ranges between 15-25%, whereas the success rate of AID (Artificial insemination by Donor) is slightly higher at 20-30%, mainly due to the use of high-quality donor sperm.

How Does Artificial Insemination Work?

Artificial insemination is a straightforward, painless procedure that involves several key steps:

1. Ovarian Stimulation

To improve the chances of conception, mild doses of fertility hormones (gonadotropins) are given to stimulate follicular development. The response is closely monitored through ultrasound scans.

2. Inducing Ovulation

When an ultrasound confirms that the ovarian follicles have reached an optimal size (around 18 mm), an hCG injection is administered to trigger ovulation. The insemination procedure is then scheduled approximately 36 hours later.

3. Preparing the Sperm Sample

The semen sample is processed in a laboratory to isolate the most motile sperm, enhancing the chances of fertilisation.

4. The Insemination Procedure

A thin catheter is used to insert the processed sperm directly into the uterus. This procedure is quick and painless and does not require anaesthesia.

5. Luteal Phase Support

Progesterone supplements administered orally or vaginally; help support the implantation of the fertilised egg in the uterine lining.

Types of Artificial Insemination

Artificial insemination can be categorized based on the sperm source and the location where sperm is placed:

Based on Sperm Source:

Artificial Insemination with Partner’s Sperm (AIH)

Artificial Insemination with Donor Sperm (AID) Based on Sperm Placement:
Intrauterine Insemination (IUI): Sperm is placed directly in the uterus (most common method).
Intracervical Insemination (ICI): Sperm is deposited in the cervix.
Intratubal Insemination (ITI): Sperm is placed inside the fallopian tubes.
Intravaginal Insemination (IVI): Sperm is introduced into the vagina, mimicking natural intercourse.
Intrafollicular Insemination (IFI): Sperm is inserted into the ovarian follicle.

Among these, IUI is the most widely performed because it offers higher success rates compared to the other methods.

Who Can Benefit from Artificial Insemination?

AI (Artificial insemination) is recommended for individuals or couples dealing with various fertility challenges, including:

Indications for AIH (Partner’s Sperm)

Cervical factor infertility, where cervical mucus prevents sperm movement.
Mild male infertility, such as slightly low sperm count or motility issues.
Ovulation disorders, including Polycystic Ovary Syndrome (PCOS) or irregular cycles.
Unexplained infertility, where standard fertility tests do not reveal a clear cause.
Immune infertility, where the woman’s immune system mistakenly attacks sperm.
Sexual dysfunction, such as erectile dysfunction, vaginismus, or retrograde ejaculation.

Indications for AID (Donor Sperm)

Single women or lesbian couples who wish to conceive.
Severe male infertility, where achieving pregnancy with the partner’s sperm is unlikely.
Genetic disorders in the male partner that cannot be screened through genetic testing.
Sexually transmitted infections (STIs) in the male partner that could be passed on.

Requirements for Artificial Insemination

For AI to be effective, specific criteria must be met:

A functional fallopian tube must be present, confirmed through hysterosalpingography (HSG) or laparoscopy.
The sperm sample should contain at least 3 million motile sperm after processing.
The patient must be free from infections such as HIV, hepatitis, syphilis, rubella, or toxoplasmosis.
Age is a key factor—fertility declines after 36 years, and for women over 38 years,

IVF is often the preferred option.

Success Rates of Artificial Insemination

The effectiveness of AI depends on factors such as age, sperm quality, and overall reproductive health. The average pregnancy rates per cycle are:

• AIH (partner’s sperm): 12-16%

• AID (donor sperm): 18-22%

Repeated cycles of AI improve the chances of success. Up to four cycles may be attempted before considering IVF, with cumulative success rates reaching 35%.

Advantages of Artificial Insemination Over IVF

Why Choose AI?

Minimally invasive – Unlike IVF, AI does not involve egg retrieval or surgery.
More affordable – The cost is significantly lower compared to IVF.
Closer to natural conception – The sperm is simply placed in the uterus, but fertilization happens naturally.
Lower hormone stimulation – Milder hormonal treatments make AI a gentler process.

Key Differences from IVF

AI requires functional fallopian tubes, whereas IVF bypasses them.
AI only uses the woman’s own eggs, while IVF allows the use of donor eggs.
AI is less expensive but has a lower success rate compared to IVF.

Potential Risks and Side Effects of Artificial Insemination

Although AI is a safe and well-tolerated procedure, some risks exist:

Ovarian Hyperstimulation Syndrome (OHSS): Rare in AI due to mild hormone stimulation.
Multiple pregnancies (twins or triplets): Can occur when multiple follicles are stimulated.
Ectopic pregnancy: Occurs in 4% of AI cases, compared to 0.8% in natural pregnancies.
Miscarriage: Early pregnancy loss occurs in about 20% of cases.
Infections: Extremely rare, with an incidence rate of 0.07% per cycle due to strict sterilization measures.

Final Thoughts: Is Artificial Insemination Right for You?

Artificial insemination is an effective fertility treatment for couples with mild infertility, same-sex female couples, and single women looking to conceive. It offers a low-risk, cost-effective alternative to IVF, with reasonable success rates.

If you have been trying to conceive for over a year without success, consulting a fertility specialist can help determine whether IUI is the right option for you.

Have questions or experiences to share? Let us know in the comments below!

Artificial Insemination (IUI): A Simple and Effective Fertility Solution